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November 2004

Is Intensive Management of Blood Pressure to Prevent Visual Loss inPersons With Type 2 Diabetes Indicated?

Arch Ophthalmol. 2004;122(11):1707-1709. doi:10.1001/archopht.122.11.1707

The Diabetic Retinopathy Study showed the efficacy of panretinal photocoagulationin preventing severe loss of vision in persons with proliferative diabeticretinopathy.1 The Early Treatment DiabeticRetinopathy Study (ETDRS) showed that focal and grid laser photocoagulationreduced the incidence of significant visual loss of 3 lines or more due todiabetic macular edema.2 While photocoagulationprevents loss of vision in many persons with diabetes, it is not without costsand complications, and may not always prevent the progression of disease orloss of vision.3 More recently, there has beeninterest in new surgical interventions, such as intravitreal injections ofsteroids and anti–vascular endothelial growth factors, to treat eyeswith diabetic macular edema and proliferative diabetic retinopathy.4 These surgical interventions should be thought ofas a tertiary prevention of more advanced complications associated with diabeticretinopathy.